- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT02025868
Third Line Antiretroviral Treatment Optimization in Sub-Saharan Africa (THILAO)
Systematic "Adherence Intervention" Phase Before Switching to 3rd-line ART in Patients With 2nd-line ART Virologic Failure in Sub-Saharan Africa : a Phase 2b Non-randomized Study.
Thilao is a multi-country, phase 2b, non-randomized study, in Burkina Faso, Cote d'Ivoire, Mali and Senegal, West Africa.
HIV-1 adults with 2nd-line ART virologic failure (plasma HIV-1 RNA >1000 copies/ml) will be recruited and followed in two phases:
- First, a 12-week intentive adherence reinforcement phase, during which patients will continue 2nd-line ART, be seen repeatidly for counseling and educational training on adherence, and be offered the possibility of phone, SMS and home visit contacts with social workers;
Second, a 48-week phase, during which:
- Patients successfully resuppressed at the end of the first phase will continue 2nd-line ART and adherence reinforcement;
- Patients with persitent virologic failure will switch to a darunavir/r + raltegravir-based 3rd-line ART.
Genotype resistance tests will be performed retrospectively on frozen samples. The main outcome will be the percentage of patients with plasma HIV-1 viral RNA <50 copies/ml at 64 weeks.
연구 개요
상태
정황
상세 설명
Main objective
To estimate, in sub-Saharan African HIV-1 infected adults who failed a NNRTI-base first-line ART and then a PI-based second-line ART:
- The efficacy (and associated factors) at 12 weeks of an intensive 3-months adherence reinfrocement phase;
- In patients who successfully resuppress at 12 weeks: The percentage of patients still with continuing succesfull virologic supression on 2nd-line ART at 64 weeks (and factors associated to success) ;
- In patients with persistent failure at 12 weeks : The efficacy (and associated factors) at 64 weeks of a darunavir/r + raltegravir-based 3rd-line regimen.
Number of participants : 200
Main outcome :
- At 12 weeks : Proportion of patients with a plasma HIV-1 RNA <400 copies/ml and/or with a decrease in plasma HIV-1 RNA >2 log10 copies/ml between inclusion and 12 weeks;
- At 64 weeks : proportion of patients with a plasma HIV-1 RNA <50 copies/ml.
Inclusion criteria:
- Age >18 years
- Documented HIV-1 infection.
- History of failing a NNRTI-based 1st-line ART
- Current PI-based 2nd-line ART >6 months
- Plasma HIV-1 RNA >1000 copies/ml
- Signed informed consent
연구 유형
등록 (실제)
단계
- 2 단계
연락처 및 위치
연구 장소
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Bamako, 말리
- Centre d'Ecoute, de Soins, d'Animation et de Conseils (CESAC)
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Bamako, 말리
- CHU point G
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Bobo-Dioulasso, 부키 나 파소
- CHU Souro Sanou
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Ouagadougou, 부키 나 파소
- CHU Yalgado Ouedraogo
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Dakar, 세네갈
- CHU Fann
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Abidjan, 코트디부아르
- Centre de Prise en Charge et de Formation (CePReF), Association ACONDA
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Abidjan, 코트디부아르
- Service des Maladies Infectieuses et Tropicales (SMIT)
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Age >18 years
- Documented HIV-1 infection
- History of failing a NNRTI-based 1st-line ART
- Current PI-based 2nd-line ART >6 months
- Plasma HIV-1 RNA >1000 copies/ml
- Signed informed consent
Exclusion Criteria:
- HIV-2 infection
- Any Severe clinical event under exploration
- History of treatment including darunavir or raltegravir.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Adherence reinforcement before switch to 3rd-line ART
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Directly observed treatment at home (family or relatives DOT); pillboxes; phone calls; SMS; home visits; adherence reinforcement sessions by trained health workers.
Second-line ART regimen : ongoing regimen at the time of inclusion will be continued. Third-line ART regimen : Darunavir/r + Raltegravir + 2 NRTIs (as chosen by the investigators) |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Virologic efficacy of the adherence reinforcement intervention
기간: Week 12
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Proportion of patients with plasma viral load <400 copies/ml at Week 12 and/or with a decrease in plasma viral load >2 log10 copies/ml between inclusion and Week 12
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Week 12
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Persistent virologic efficacy of the adherence reinforcement intervention
기간: Week 64
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Proportion of patients with plasma viral load <50 copies/ ml at Week 64 among those who stayed on 2nd-line ART at Week 16
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Week 64
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Virologic efficacy of 3rd-line ART
기간: Week 64
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Proportion of patients with HIV-1 plasma viral load <50 copies/ml at Week 64 among those with persistent failure at Week 12 who switched to 3rd-line ART
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Week 64
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Immunological efficacy of the adherence reinforcement intervention
기간: Week 12
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CD4 count evolution between inclusion and Week 12
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Week 12
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Immunological efficacy of 3rd-line ART
기간: Week 64
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CD4 count evolution between Week12 and Week 64 among patients who switched to 3rd-line ART at Week 16
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Week 64
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Tolerance of 3rd-line ART drugs
기간: Week 64
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Incidence of grade 3-4 adverse events (ANRS grading table) in patients on 3rd-line ART
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Week 64
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Adherence to 3rd-line ART
기간: Week 64
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3rd-line Medication Possession Ratio between Week 16 and Week 64
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Week 64
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Resistance to 1st and 2nd-line antiretroviral drugs
기간: Week 12
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Resistance mutations to antiretroviral drugs among patients with virological failure at Week 12
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Week 12
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Resistance to 1st, 2nd and 3rd-line antiretroviral drugs
기간: Week 64
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Resistance mutations to antiretroviral drugs among patients with virological failure at Week 64
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Week 64
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Plasma antiretroviral drugs concentration
기간: Week 12
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Plasma antiretroviral drugs concentration at Week 12
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Week 12
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Plasma antiretroviral drugs concentration
기간: Week 64
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Plasma antiretroviral drugs concentration at Week 64
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Week 64
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공동 작업자 및 조사자
수사관
- 수석 연구원: Serge P. Eholié, MD, MSc, Pr, Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire
- 수석 연구원: Roland Landman, MD, Institut de Médecine et d'Epidémiologie Appliquée - Hôpital Bichat Claude Bernard, Paris, France
- 연구 의자: Pierre-Marie Girard, MD, PhD, Infectious Diseases Department, University Hospital Saint Antoine, Paris, France
- 연구 책임자: Xavier Anglaret, MD, PhD, Inserm 897, University of Bordeaux, France
간행물 및 유용한 링크
유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- ANRS 12269 THILAO
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